Differential diagnosis
The differential diagnosis for cryptococcal meningitis is:
- tuberculous meningitis:
- fever is a major feature
- chest radiograph demonstrates characteristic lesions
- SIADH results in a low plasma sodium
- TB organisms will be seen and cultured in the CSF (1)
- granulomatous vasculitis:
- CSF glucose is normal
- CSF glucose is normal
- progressive multifocal leukoencephalopathy:
- CSF is normal
- CSF is normal
- unidentified viral meningitis:
- CSF glucose is normal
- CSF glucose is normal
- neurosarcoid:
- serum and CSF ACE may be elevated
- serum and CSF ACE may be elevated
- malignant infiltration of the meninges:
- neoplastic cells seen in the CSF
Reference
- Stadelman AM, Ssebambulidde K, Buller A, et al. Cerebrospinal fluid AFB smear in adults with tuberculous meningitis: a systematic review and diagnostic test accuracy meta-analysis. Tuberculosis (Edinb). 2022 Jul;135:102230.
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